Provider Demographics
NPI:1144429218
Name:MAGALLANES, JUNE PANGANIBAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JUNE
Middle Name:PANGANIBAN
Last Name:MAGALLANES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JUNE
Other - Middle Name:DOMINGUEZ
Other - Last Name:PANGANIBAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:200 REYNOLDS AVE
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-3326
Mailing Address - Country:US
Mailing Address - Phone:973-887-8080
Mailing Address - Fax:973-386-5906
Practice Address - Street 1:200 REYNOLDS AVE
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-3326
Practice Address - Country:US
Practice Address - Phone:973-887-8080
Practice Address - Fax:973-386-5906
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08252600207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine